Adopted in May 2013

A cochlear implant (CI) is a small, complex electronic device that can help to give auditory input to a person who is profoundly deaf or severely hard of hearing. Auditory information is transformed into electrical impulse that is directly delivered to the cochlear nerve, creating a sound sensation in the brain. CIs were first developed in the 80s for deafened adults that had a certain level of hearing before. Even babies now receive implants. Studies show that children who have a CI will still have some hearing deficit; CIs are not super hearing aids and results vary greatly. The child will need long-term intensive training with the support of qualified speech therapists to attain a sustainable level of speech. It is not guaranteed that all children will master this during their lives, which makes adequate language input in the form of sign language indispensable.

EUD is strongly against pressures on parents to implant their child without giving them information on the various options available. Marschark (2001) highlights: "CIs do not change deaf children into hearing children, they act more like hard of hearing children'". This is an important factor when dealing with implanted children, as they have to be given adequate language input to access education equally and easily without language barriers.

More and more children deaf children are implanted at a very young age. EUD is increasingly concerned about parents not being given balanced and well-researched information regarding sign language and Deaf culture, as well as bilingual education in sign language and the national language. Parents must be able to make an informed choice when having to decide for or against a cochlear implant. It should be widespread practice that doctors and social workers give impartial information drawing on evidence-based and multidisciplinary research covering speech perception/production in conjunction with actual educational outcomes. This must include access to a Deaf role model, information about the rich Deaf culture, including sign language, as well as access to sign language learning for both the parents (including siblings or other close family members) and the deaf child.

Researchers often misunderstand the relationship between receiving auditory information with the help of technical devices and being able to follow and understand conversation. Therefore, EUD actively supports both implanted and deaf children in learning the national sign language from birth, which is the only language that is fully accessible for deaf and hard of hearing children and adults even in large conversation groups. National sign languages are natural languages that have their own grammar and lexicon, just as any spoken language. Sign languages are enshrined in legislation all over Europe and the world, ranging from constitutional recognition to language laws, and disability laws among others (Wheatley & Pabsch 2010).

EUD stresses the fact that educational approaches need to be matched to the individual child's needs (see also Preisler 2001) and the personal environment. There is no evidence that sign language acquisition hinders the learning of a spoken language. Giezen's (2011) conclusion makes it clear that implanted children should at least be given some signed input as it "can provide the means for effective early parent-child interaction and can provide important foundations for cognitive, linguistic and social development".

Marschark (2009) clearly states that "fluency in sign will support spoken language development when the ability to perceive auditory information - through use of a cochlear implant for example - is attained" leading both Marschark (2009) and Szagun (2010) to conclude that CI implanted children cannot lose anything by learning a natural sign language and explain that a child should be given the opportunity to choose for themselves later which language they prefer generally or in a certain environment. Bilingualism has been proven to be of cognitive advantage and additionally increases the child's social and professional opportunities.

Deafness, as other disabilities, is still seen as a medical condition with a possible technological solution. The medical ambition to cure deafness based on a medical model rather than a social model of disability cannot be the only solution especially in view of the UN Convention on the Rights of Persons with Disabilities, which clearly gives deaf people the right to sign language. This must include all children who are implanted, even at an early age to ensure their cognitive health.

EUD would like to thank Donna Jo Napoli for her invaluable input to this paper.


References and Further Reading:

Deutsche Gesellschaft der Hörgeschädigten - Selbsthilfe und Fachverbände e.V. (2010). Resolution zur einseitigen Beeinflussung von Eltern hörbehinderter Kinder zum Cochlea - Implantat (CI). Available at:  (Accessed on 14 February 2011).

De Meulder, M. & Crasborn, O. (2010). Sign language is indispensable in the education of children with a CI. Manuscript. Available at: pages/515325/sign_langauge_in_education_de_meulder_crasborn.pdf (Accessed on 30 March 2011).

Giezen, M. (2011). Speech and Sign Perception in Deaf Children with Cochlear Implants. Utrecht: LOT.

Grosjean, F. (n.d.). The Right of the Deaf Child to Grow up Bilingual. Available at:  (Accessed on 22 March 2011).

Humphries, T., Kushalnagar, P., Mathur, G., Napoli, D.J., Padden, C., Rathmann, C., & Smith, S. (forthcoming). The right to language: Ethical considerations, ideal situation, and practical measures toward reaching the ideal, Cochlear Implantation. In: C Umat & D L Saim (eds.): InTech. Available at:  (Acessed on 6 November 2013).

Marschark, M. (2001). Language Development in Children Who Are Deaf: A Research Synthesis. Rochester: National Technical Institute for the Deaf.

Marschark, M. (2009). Evidence of Best Practice Models and Outcomes in the Education of Deaf and Hard-of-Hearing Children: An International Review. Trim: NCSE.

Mayer, C. & Leigh, G. (2010). The changing context for sign bilingual education programs: issues in language and the development of literacy. In: International Journal of Bilingual Education and Bilingualism, 13: 2, pp. 175-186.

Preisler, M. (2001). Cochlear Implants in Deaf children. Strasbourg: CoE Publishing.

Szagun, G. (2010). Sprachentwicklung bei Kindern mit Cochlea-Implantat. Available at:  (Accessed on 22 March 2011).

Schick, B., Williams, K. & Kupermintz, H. (2006): Look Who's Being Left Behind: Educational Interpreters and Access to Education for Deaf and Hard-of-Hearing Students. In: Journal of Deaf Studies and Deaf Education 2005 (Winter 2006) 11 (1), pp. 3-20.

Wheatley, M. & Pabsch, A. (2010). Sign Language Legislation in the European Union. Brussels: EUD.

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